Skin treatment appliances which are used for generalized treatment of skin are well known. One example, among others, is shown in U.S. Pat. No. 7,320,691, owned by the assignee of the present invention. However, many skin conditions occur as spots, i.e. localized irregularities within a specific area, generally less than a few centimeters in diameter. In many such cases, it is unnecessary to treat larger skin areas, when attempting to provide treatment to small area irregularities. Further, an individual may have several spots, each of which require a different form of treatment. As examples, these spots or irregularities may include surface blemishes, age spots, specific skin discolorations, clogged pores, acne, various wounds, insect bites, rashes, rosacea, ingrown hairs, warts, tattoos and other irregularities. Each of these conditions can be best treated with its own regimen and may require a specific device and/or a specific formulation with an active ingredient. Each of these treatments typically requires a workpiece with an active element designed specifically for treatment, including activation of a specific formulation. It is not efficient or reasonable to expect a consumer to purchase separate devices for numerous different specific skin conditions. Accordingly, it would be desirable for a single appliance to be adaptable to treat a wide variety of spot skin irregularities.